Clinical Ethics

The Department of Bioethics on Cleveland Clinic's main campus has provided clinically-based services in support of quality patient care since 1984. The Department is part of the Center for Ethics, Humanities and Spiritual Care, and includes professional staff and fellows with various backgrounds (e.g., medicine, philosophy, health policy, law, theology, education, bioethics), as well as administrative support.

Clinical programs and services of the Department include:

Ethics Consultation

Ethics Education

Ethics-related policy revision and recommendation

ICU Multidisciplinary Rounds

Selection Team Participation for Transplantation, Heart Failure, and Neurological Interventions

Support for the Ethics Committee

The Department also provides support and staffing for the Clinical Ethics services and programs at the Cleveland Clinic regional hospitals in the greater Cleveland area. (See Regional Hospitals tab).

The Ethics Committee

The Ethics Committee on Cleveland Clinic's main campus consists of a multidisciplinary group of healthcare professionals and a representative from the community. These individuals bring together knowledge of ethics and ethical analysis, group process skills, and a wide range of backgrounds and expertise.

The Ethics Committee meets monthly on Cleveland Clinic's main campus to discuss and address patient care issues and ethics-related policies and procedures. The Ethics Committee also networks with other institutional committees and organizational leaders in an effort to enhance the understanding of ethical issues throughout the hospital and to promote the ethical care of patients and families. Committee members also serve as ethics consultation resources to help resolve complex ethical issues that have institutional implications.

Ethics Consultation Services

The Ethics Consultation Service (ECS) on Cleveland Clinic's main campus responds to requests for help to resolve ethical conflicts, issues, or questions involving patient care. It functions as a resource when patients, family members or health care professionals have reached the limits of their own personal or professional abilities to address ethical questions; when there is ethical uncertainty; or when individuals need ethical verification or a sounding-board for ethically supportable strategies and action steps.

Ethics consultation is intended to support but not replace usual channels of communication about ethically challenging situations.

The ECS on the main campus is staffed 24 hours a day, 7 days a week by bioethicists and fellows from the Department of Bioethics. Ethics Consultation is advisory. Patients, family members, and health care professionals remain responsible for their own decisions.

Cleveland Clinic offers this service free to patients, family members and health care professionals. A patient or anyone involved in caring for a patient can request an Ethics Consultation without fear of intimidation or reprisal. All discussions are confidential.

When to Request an Ethics Consultation

Examples for appropriately requesting an ethics consultation include:

Efforts by patient, family and health care providers to resolve an ethical issue have reached an impasse.

Decisions need to be made about life-sustaining treatment for a patient who lacks decision-making capacity and for whom an appropriate surrogate decision maker cannot be found.

A patient’s surrogate decision maker is unable or unwilling to provide a substituted judgment as to what the patient would have wanted.

Health care professionals wish to discuss ethically supportable strategies that could help to prevent an “ethics crisis.”

The case is ethically challenging, unusual, unprecedented, or complex.

How to Request an Ethics Consultation

Health care professionals, patients and family members can directly request an Ethics Consultation by calling the hospital operator and asking for the ECS. Patients and family members can also inform their nurse or other health care professionals that they want an Ethics Consultation. Staff made aware of a patient or family desire for an Ethics Consultation should convey the request to the ECS.

The Ethics Consultant will notify the Attending Physician or his/her designee about the request for an Ethics Consultation.

The ECS on the main campus can be reached during business hours by calling the Department of Bioethics at 216.444.8720. All other times the Bioethicist on-call can be paged at 14-22512.

Regional Hospitals

Each Cleveland Clinic health system regional hospital has its own Ethics Committee. As on the main campus, these committees consist of a multidisciplinary group of health care professionals and community representatives who contribute to the committees’ three primary purposes:

staffing and supporting the Ethics Consultation Service (ECS)

providing Ethics Education, and

reviewing and developing ethics-related policies.

Each Committee’s activities are supported by Staff Bioethicists.

Ethics Committee Membership rosters are available upon request. Please contact the appropriate Bioethicist:

Ethics Consultation at Regional Hospitals

The ECS at each hospital responds to requests for help to resolve ethical conflicts, issues, or questions involving patient care. Each ECS functions as a resource for patients, family members or health care professionals when there is ethical uncertainty or the need for ethical validation. Ethics consultation is intended to support but not replace usual channels of communication about ethically challenging situations.
Ethics Consultation is advisory. Patients, family members, and health care professionals remain responsible for their own decisions.

Cleveland Clinic regional hospitals offer this service free to patients, family members and health care professionals. A patient or anyone involved in caring for a patient can request an Ethics Consultation without fear of intimidation or reprisal. All discussions are confidential.

Examples for appropriately requesting an ethics consultation include:

Efforts by patient, family and health care providers to resolve an ethical issue have reached an impasse.

Decisions need to be made about life-sustaining treatment for a patient lacking decision-making capacity and an appropriate surrogate decision maker cannot be found.

A patient’s surrogate decision maker is unable or unwilling to provide a substituted judgment as to what the patient would have wanted.

The medical team has concerns about the best interests of a patient unable to make his or her own decisions.

The case is ethically challenging, unusual, unprecedented, or complex.

Families need additional support thinking about what factors to consider and how to apply the standard of “substituted judgment” to decisions for a patient.

Health Professionals, patients and family members can directly request an Ethics Consultation by calling the specific hospital’s operator and asking for the ECS. Because each hospital has its own process for ECS requests, callers may be directed to Pastoral/Spiritual Care, the Ombudsman, another department, or directly to the Bioethicist. Patients and family members can also inform their nurse or other health care professionals that they want an Ethics Consultation. Staff made aware of a patient or family desire for an Ethics Consultation should convey the request to the ECS.

The Ethics Consultant will notify the Attending Physician or his/her designee about the request for an Ethics Consultation.

The ECS can also be reached during business hours directly. Please see below for the contact information for each hospital.

Euclid Hospital216.531.9000, ext. 65404

Fairview HospitalPastoral Care: 216.476.7067

Hillcrest Hospital

Lakewood Hospital Ombudsman: 216.529.7049

Lutheran Hospital Pastoral Care: 216.363.2158

Marymount Hospital Pastoral Care or Medical Staff: 216.581.0500

Medina Hospital Ombudsman: 330.721.5330
Pastoral Care: 330.721.5188

SouthPointe Hospital
Ethics Referral Line: 216.491.7886

The ECS on the main campus can be reached during business hours by calling the Department of Bioethics at 216.444.8720. All other times the Bioethicist on-call can be paged at 14-22512.